Receiving or not Deemed Necessary Healthcare Services

Background: Avoiding deemed necessary healthcare needs may worsen prognosis and treatment options, and damage people’s ability to perform their roles in society. Our study investigates why people avoid healthcare services in an upper-middle-income country, Turkey. Methods We apply TurkStat’s 2012 Health Survey Data that includes a comprehensive health and social-demographic information of 28,055 survey participants who were 15 + aged. We prefer to use bivariate probit model to analyze the avoiding behaviour in inpatient level in accordance with outpatient level because of the observed significant correlation between people’s avoiding behaviour under tertiary and lower level of health care. Results According to our descriptive analysis, we see that 2.6% of 15 + aged population were avoiding deemed necessary hospital services. Furthermore, it is found that high cost (31%), organizational factors (21%) and fear (12%) are prominent reasons of avoiding tertiary care. Thereafter, in our bivariate probit model findings, we figure out that being covered by social security schemes decreases the probability of avoiding both outpatient and inpatient health services by 6.9%. Moreover, being female, living in rural area, having lower income increase the chance of being avoider in both stages of healthcare. Conclusions We conclude that social inequalities were main underlying determinants of the avoiding behavior. As health and effective provision of health care are vital for the smooth functioning of society, we suggest that improve health care protection of people from disadvantaged social groups and develop better organizational factors to prevent difficulty of having treatment at policlinics.